Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | N5662 | TX |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | N5662 | TX |
N | 207XS0106X | Orthopaedic Hand Surgeon | N5662 | TX |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | N5662 | TX |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | N5662 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | N5662 | TX |
N | 207XX0801X | Orthopaedic Trauma Surgeon | N5662 | TX |
NPI | 1083753925 |
---|---|
Provider Name | Matthew Michael Dwyer |
First Address | San Antonio, TX 78258-4347 |
Second Address | San Antonio, TX 78258-4347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 29/08/2011 |